Standardized pathway for outpatient ambulatory fracture surgery
Editor's Note In this study, an outpatient fracture pathway greatly improved the efficiency and timeliness of care, and it reduced costs. A total of 187 patients during the preintervention period and 308 patients during the intervention period were eligible for the ambulatory pathway. Those managed as outpatients increased from 1.6%…
Survey: MRI procedures up 8%, AI to improve image quality and workflow
Editor's Note A survey by IMV Medical Information Division finds that the number of MRI procedures performed in the US rose 8% from 39 million in 2018 to an all-time high of some 42 million in 2019, the January 15 AuntMinnie.com reports. A total of 17% of respondents gave high…
Mastering predictive modeling to improve patient care
The Best in OR Business Award is presented annually at the OR Business Management Conference to recognize an outstanding leader who has saved on costs, increased OR utilization, improved patient safety, or otherwise streamlined the surgical services department. The 2020 award will be presented to Vikram Tiwari, PhD, associate professor…
Develop standard work for successful ERAS implementation
At Virginia Commonwealth University (VCU) Health System in Richmond, implementation of Enhanced Recovery After Surgery (ERAS) incorporates principles of Lean thinking, a management methodology that emphasizes “…maximize[ing] customer value while minimizing waste. Simply, lean means creating more value for customers with fewer resources,” according to the Lean Enterprise Institute.1 Several…
Can your hospital survive the growing dominance of ASCs?
Of the approximately 57 million surgical procedures performed annually in the US, it is estimated that hospital inpatient procedures (overnight admissions) account for less than 20% of cases. Many procedures once performed in hospital outpatient surgery departments (HOPDs) have moved to ambulatory surgery centers (ASCs) over the past 15 years,…
FCOTS increase through smarter scheduling and surgeon accountability
Starting the first cases of the day on time is key for maintaining the OR schedule. A delay in first case on-time starts (FCOTS) can lead to less OR utilization, greater facility costs, and dissatisfaction among physicians, OR staff, and patients. It’s a problem in many surgical suites, but when…
Can punctuality decrease OR costs?
Editor's Note In this study from Washington University School of Medicine, St Louis, a first case on-time starts (FCOTS) improvement initiative was linked to a higher frequency of FCOTS, which was independently associated with last case on-time ends (LCOTE) and decreased OR overtime costs. Of 12,073 cases (6,095 pre- vs…
Is your staff ready to manage malignant hyperthermia?
Malignant hyperthermia (MH) is a rare but life-threatening surgical complication that seems to turn the effects of general anesthesia upside down. Instead of relaxing, muscles become rigid, releasing large amounts of acid and potassium into the blood. Instead of a normal slowing of breathing, respirations quicken, and end-tidal CO2 rises.…
Reinvent and reap the rewards of improved handoffs--Part 1
A care transition poses a danger point for patients—failing to “hand off” needed information from one clinician to another can lead to significant morbidity and mortality. The Joint Commission was so concerned about handoffs that in 2017 it issued a sentinel event alert on the topic. “Handoffs are a safety…
Well-crafted handoff tools save valuable time in OR schedule
In 2017, the Joint Commission issued a Sentinel Alert Event on the problem of inadequate handoff communication, focusing attention on this vital aspect of care. (See related story, p 22.) Clinicians and leaders agree that handoffs are important, but implementing them effectively can be challenging, particularly in the fast-paced perioperative…
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